In view of the severe damage caused by unyielding, low residual volume cuffs, various modifications to the cuff of an intratracheal tube have been introduced. The merits of two low-pressure cuffs were assessed in an experimental study in dogs; both cuffs produced little visible damage to the tracheal wall in dogs intubated continuously over a two-week period. A modified technique of producing tantalum tracheobronchograms without distrubing the mucous blanket or traumatizing the tracheal wall is described. These tantalum radiological studies demonstrated a progressive temporary increase in size of the trachea at cuff level over the period of intubation with these cuffs. The implications of such a progressive weakness occurring in the tracheal muscle are discussed.
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